银屑病关节炎患者皮损进展与血清总IgE及IL-6、TNF-α水平的关系

Relationship between progression of skin lesions and serum total IgE, IL-6,TNF-α levels in patients with psoriatic arthritis

目的通过检测银屑病关节炎(Psoriaticarthritiss,PsA)患者血清免疫球蛋白E(Immunoglobulin E,IgE)及细胞因子IL-6(Interleukin-6)、TNF-α(Tumor necrosis factor-α)水平,探讨皮损加重与Ⅰ型超敏反应的关系,寻找PsA的关节炎及皮损是否有关联性。方法收集2019年1月1日~6月30日在潍坊市人民医院风湿免疫科住院及门诊确诊为PsA患者50例,采用酶联免疫测定法测定PsA患者皮损加重期血液中IgE及IL-6、TNF-α水平,作为疾病活动期指标,采集所选50例患者复诊时皮损较前明显缓解的血清IgE水平作为疾病稳定期指标,并进行相关性统计学分析。结果患者疾病活动期血清IgE水平较稳定期升高,差异有统计学意义(P<0.05)。疾病活动期IL-6、TNF-α水平高于正常值上限,两个变量之间互相存在显著弱相关关系(P<0.05,相关系数=0.343)。活动期IgE与IL-6呈弱相关关系(P<0.05,相关系数=0.315),IgE与TNF-α,差异无统计学意义(P>0.05)。结论 PsA患者皮损加重严重程度与血清IgE、IL-6、TNF-α水平升高呈正相关,三者均可反映疾病发展严重程度,PsA关节炎及皮损两种症状之间有一定关联性。Ⅰ型超敏反应是PsA患者皮损的病因之一,可以通过防止Ⅰ型超敏反应进而有效地进行临床预防和治疗。

Objective To investigate the relationship between skin lesion aggravation and type Ⅰ hypersensitivity and to find the association of arthritis and skin lesions in PsA by detecting the levels of serum immunoglobulin E(IgE), and cytokines IL-6(Interleukin-6), TNF-α(tumor necrosis factor-α) in patients with psoriatic arthritis(PsA). Methods Fifty patients with PsA were enrolled in the Department of Rheumatology and Immunology, Weifang People’s Hospital from January 1 to June 30, 2019. The serum levels of IgE and IL-6, TNF-α in patients with PsA exacerbation, as indicators of disease activity period, were measured by enzyme-linked immunosorbent assay. The serum IgE level of the 50 patients with skin lesions significantly relieved at the time of follow-up was collected as the stable period index, and the correlation statistical analysis was performed. Results Serum IgE levels in patients with disease in active phase were higher than those in stable phase(P<0.05). The levels of IL-6 and TNF-α in the active phase of the disease were higher than the upper limit of normal value, and there was a significant weak correlation between the two variables(P<0.05, correlation coefficient=0.343). There was a weak correlation between IgE and IL-6 in active period(P<0.05, correlation coefficient=0.315), and the difference in the correlation of IgE and TNF-α was not statistically significant(P>0.05). Conclusion The severity of increased skin lesions in patients with PsA is positively correlated with the increase of serum IgE, IL-6 and TNF-α levels. All three can reflect the severity of disease development, and there is a certain relationship between PsA arthritis and skin lesion. Type Ⅰ hypersensitivity is one of the causes of skin lesions in patients with PsA, and can be effectively prevented and treated clinically by preventing type Ⅰ hypersensitivity.